Coup Contrecoup Brain Injury: What to Expect and How to Get Legal Help


May 17  

Statistics about traumatic brain injury (TBI) in the United States, including coup countercoup injuries, prove sobering. Annually, there are about 1.5 million Americans diagnosed with TBIs, and 50,000 of those die as a result of their injuries. Of the 230,000 people that get hospitalized and survive, between 80,000 and 90,000 of them struggle for the rest of their lives with TBI-related impairments.

When you look at cumulative figures, TBI casualty rates point to an even more shocking trend. Around 5.3 million Americans live with permanent disabilities and symptoms associated with TBIs. Many of these come from a coup contrecoup injury. Read on to learn more about head injuries associated with car and motorcycle accidents and what legal means you have as a victim of such an injury.

Types of TBIs

The majority of TBIs result from an outside force colliding with your head. These TBIs get diagnosed into three categories based on the type of damage inflicted, where, and how. These three types of TBIs are:

  • Coup injury
  • Contrecoup injury
  • Coup contrecoup injury

The term coup (pronounced coo) hearkens back to 18th-century French and means “a stroke or blow.” The word contre (pronounced contra) also comes from French and means “against.” You may sometimes see countrecoup spelled “contra coup” but this spelling is incorrect. So, contrecoup literally means “against blow” and coup contrecoup means “blow against blow.”

As we learn more about how car and motorcycles accidents contribute to these types of injuries, you’ll gain an instant appreciation for the literal meanings of these terms. It will help you to identify their differences, too.

Whether a coup, countrecoup, or coup contrecoup trauma, all three conditions are categorized as non-penetrating injuries. They have many different causes, including:

  • sports-related injuries
  • trauma from falls
  • blunt force trauma
  • motorcycle and car accident-related injuries

For the purposes of this article, we’ll focus on TBIs related to car and motorcycle accidents.

Take These TBI Symptoms Seriously

Before we delve into what each of these brain traumas looks like, remember that you need to take any type of traumatic brain seriously. They can prove difficult to diagnose and treat because of the hundreds of different symptoms that may manifest with each type of injury. Time is of the essence with TBIs, so get to the ER as soon as possible if you or someone you love has recently taken a blow to the head.

Attempting to shake off a concussion or grin through the pain could lead to permanent brain damage. What’s more, if left untreated, you could die. If you feel any of the following symptoms, you need to seek medical assistance right away:

  • Blurred vision
  • Affected speech
  • Confusion
  • Feeling dazed
  • Nausea
  • Vomiting
  • Headache
  • Sensitivity to noise
  • Sluggishness
  • Ringing in ears
  • Behavioral changes
  • Personality changes
  • Other abnormal feelings

Like strokes, every minute counts. TBIs can lead to problems with cerebrospinal fluid flow. They can result in life-threatening brain bleeding (hematomas) or brain swelling. Fragmented bone from skull fractures could also get embedded in brain tissue causing further damage. Don’t take any chances when it comes to head injuries.

Diagnosing TBIs

Before we delve into coup contrecoup injuries caused by vehicle accidents, let’s explore how TBIs get diagnosed. Then, we’ll compare each condition to the other. Going into this discussion, you should know that any brain trauma can prove serious. They all require timely treatment, whether a coup, contrecoup, or coup contrecoup.


First, coup injuries refer to damage at the point where the force trauma occurs. These prove among the easiest to pinpoint because the area of impact likely contains telltale cuts, contusions, bruises, or other identifying marks with the bruised brain just below. Coup injuries range in severity from mild to severe. They can lead to bruising, swelling, and even hemorrhaging when left untreated.


Second, contrecoup injuries happen on the opposite side of the brain from the point of impact. When it comes to coup vs contrecoup trauma, contrecoup conditions don’t come with visual markers such as abrasions or cuts. As a result, they often get ignored by patients and overlooked misdiagnosed by healthcare providers.

Contrecoup injuries often occur in a motorcycle crash or a vehicle rollover where the head undergoes the effects of significant force. The reason the trauma appears on the opposite side of the area of impact is that the force and speed causes the brain to strike the skull opposite the blow.

Contrecoup injuries often involve cerebral contusions or brain bruising. Left untreated, contrecoup injuries can cause severe long-term problems for victims as well as microvascular disruption, subdural hematoma, or brain hemorrhage. You may be more familiar with contrecoup injury in the context of “shaken baby syndrome.”

Coup Contrecoup

Finally, coup contrecoup injuries, as the name suggests, represent a combination of coup and countrecoup injuries. Coup contrecoup injuries affect both hemispheres of the brain, proving the most severe to treat. As you can imagine, the double impact sites in the brain can lead to a cataclysmic chain of complications and impairment.

Although the coup portion gets treated, many doctors neglect to diagnose the contrecoup element. Coup contrecoup injuries, when left untreated, can lead to permanent brain damage or even death. Timely treatment remains crucial to avoid complications such as hematomas and swelling of the brain.

How a Car or Motorcycle Crash Damages Your Brain

Brain tissue is soft and delicate. It’s not made to withstand blows and blunt force. The skull’s hard bone shielding envelopes and shields it from damage. And spinal fluid surrounds it providing extra cushioning. In this sense, then, the brain remains somewhat free floating.

During a motorcycle or car accident, the brain jostles around in the head, often at a very high rate of speed with significant force. As we previously discussed, when enough force occurs, the brain slams into the front of the skull. And if the force is powerful enough, it may even cause the brain to then bounce backward smashing into the opposite side of the skull.

These impacts can cause bruising, swelling, damage to blood cells, and damage to nerve cells. We call this a concussion. The term “concussion” doesn’t conjure up the horrific injuries that may impair a victim.

What’s more, people tend to minimize concussions because, oftentimes, few if any visible signs of the damage beneath the skull exist. Victims of TBI may also feel too embarrassed or too confused to report their mental impairments. No one likes to admit to experiencing problems with word recall, memory, uncharacteristic thoughts, depression, and more.

These confessions could lead to problems in the workplace or at home. Some sufferers of TBI do so in silence denying themselves much needed medical attention. Unfortunately, they’re only making matters worse.

The Most Common Areas of Damage

When it comes to the most common areas of the brain damaged by coup contrecoup injuries, physicians often see trauma in the frontal lobe behind the forehead and in the temporal lobe beneath the temples.

These areas of the brain control language comprehension, speaking, and decision making. Depending on the severity of the condition, patients may also experience problems with:

  • Sensory changes
  • Muscle weakness
  • Paralysis
  • Coordination
  • Balance
  • Swallowing
  • Memory
  • Concentration

These remain a short list of the hundreds of symptoms that could afflict those with coup contrecoup injuries. Time and prevention remain crucial to the treatment of TBIs, no matter the type.

Once the brain sustains injuries, they often prove irreversible. It’s crucial that doctors and surgeons act fast to prevent further complications. In mild cases, extra rest may help.

Doctors may also prescribe medication to alleviate some of the symptoms. In severe cases, where brain swelling or bleeding occur, emergency brain surgery may be required to stem the onslaught of these life-threatening complications.

What Does a Coup Contrecoup Injury Cost?

Whether a coup, contrecoup, or coup contrecoup injury, the impact can be devastating. TBIs lead to heartbreaking physical and mental impairments. But they take a financial and emotional toll, too. People suffering from TBIs have faced everything from lost wages to lost jobs to divorces as a result of their inability to recover from an accident.

According to the New York Times, “A single concussion… may have lasting repercussions on mental health and intellectual and physical functioning… and multiple head injuries increase the risks of later problems.”

TBI sufferers may face a lifetime of struggle attempting to rehabilitate, relearn, and move on with their lives. And the most severe may remain dependent on others for the rest of their lives. When these injuries result from negligence or malice on the part of another, the trauma can prove more difficult for victims to overcome.

There Is Hope

If you or someone you love is suffering from a coup contrecoup injury or another type of TBI, you may feel overwhelmed or even hopeless. You may not know what recourse you have from a legal standpoint. You may feel like you’ve run out of options, and no one is on your side.

But we can help. Contact us today for a free evaluation of your case. We have worked with many other clients suffering from the ill effects of TBI, and we’re here to provide you with the support and legal representation that you need during this difficult time.

Give me a call at 312-500-4500 for a free consultation.

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